The frequency of day surgery continues to increase worldwide. However, knowledge of the patients experiences of symptoms and discomfort beyond the first 72 hours postoperatively remains almost nonexistent. The overall aim of this study was to describe patients' experiences of symptoms and discomforts and their impact on daily living. A prospective design was used to survey 298 patients’ symptoms and discomforts as well as their impact on daily living up to three months after a day surgery in a community hospital in Sweden. A review of previous research, published between 1992 and 2008 was completed (Paper I). The first analysis of data was descriptive and correlational; focusing on patients' perception of pain, return to normal activities and daily function over time (Paper II). The second analysis was descriptive, focusing on patients' experiences and perceived causes of persisting discomfort following day surgery (Paper III). The third analysis was qualitative, using thematic analysis of two cases (Paper IV) to examine symptom experience, components of symptom management strategies and symptom status outcomes as well as influencing factors related to person, health and illness and environment domains. Paper II: On a Numerical rating scale (NRS) (0-10) 55% (n=127) of patients rated their worst pain as >4 at 48 hours, 43% (n=91) at seven days and 34% (n=26) at three months after surgery. Pain interfered at NRS >4 with work at 48 hours and seven days, then subsided, but still reported at three months. Worst pain at 48 hours correlated significantly with return to normal activity within seven days. Paper III: Varying types of discomforts was reported by 118 patients at 48 hours, 110 at seven days and 46 at three months after surgery.
Perceived causes of discomfort at three months were: type of surgery, insufficient access to provider or information and incorrect or suboptimal treatment. Paper IV: Contextual domains, Symptom Experiences, Symptom Management strategies and Symptom Status Outcomes, were used to illustrate the postoperative situation following day surgery. Concluding; despite extensive efforts, such as pain management guidelines, people may suffer for a long period after day surgery.